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Plastic and Reconstructive Surgery.... Jun 2024Lymphedema following oncologic intervention can cause significant lifelong morbidity for patients in whom conservative management fails. The associated swelling,...
Lymphedema following oncologic intervention can cause significant lifelong morbidity for patients in whom conservative management fails. The associated swelling, discomfort, pain, and recurrent cellulitis greatly diminish quality of life. Surgical procedures, including suction-assisted lipectomy, lymphovenous anastomosis (LVA), and vascularized lymph node transfers, show effectiveness in both volume reduction in affected extremities and symptom relief. However, the success of procedures like LVA is dependent on effective preoperative lymphatic mapping to identify suitable vessels for anastomosis. Traditional superficial lymphatic mapping uses near infrared fluorescence indocyanine green (ICG) imaging. Moreover, recent advances in contrast-enhanced ultrasound (CEUS) lymphography increased lymphovenous bypass target identification for LVA in the extremities. CEUS lymphography uses microbubbles as a contrast-enhancing agent injected intradermally into the affected extremity with subsequent identification of superficial collecting lymphatic vessels using ultrasound. Although a recent report noted an uptick in severe and critical adverse drug reactions to an ultrasound contrast agent injected intravenously in stress echocardiography, adverse drug reactions associated with ultrasound contrast-enhancing agents in body ultrasound are rare. The safety profile and potential complications from CEUS lymphography in the lymphedema population have yet to be fully characterized. In this case report, the authors present the first cutaneous adverse drug event following a secondary exposure to the contrast used for CEUS imaging. Mechanisms and justifications for an immune-mediated process are explored, and a review of similar manifestations in other related contrast applications is discussed.
PubMed: 38911583
DOI: 10.1097/GOX.0000000000005908 -
Cureus May 2024Background Intestinal perforation is a life-threatening condition requiring immediate surgical intervention. Surgical-site infections (SSIs) and wound dehiscence are...
Background Intestinal perforation is a life-threatening condition requiring immediate surgical intervention. Surgical-site infections (SSIs) and wound dehiscence are common complications associated with emergency laparotomy for intestinal perforation. Finding optimal wound management and postoperative strategies can significantly impact patient outcomes and reduce the risk of complications. Negative-pressure wound therapy (NPWT) is a relatively recent tool employed in the care of wounds to control SSIs and foster healing. Methodology A prospective, observational, cohort study was conducted among 150 patients who underwent emergency exploratory laparotomy due to intestinal perforation at the general surgery department of a tertiary care hospital in New Delhi between July 2022 and December 2023. Preoperatively, all patients underwent initial resuscitation. Intraoperatively, the extent of peritonitis was determined and was categorized according to the Centers for Disease Control and Prevention (CDC) classification. Postoperatively, NPWT dressing was applied to the patient's midline laparotomy wound on postoperative day (POD) two. Negative pressure was set at 75-125 mmHg with suction. The number of NPWT dressing changes required was documented. The wound was closed with vertical mattress sutures under local anesthesia, delayed primary closure (DPC). The incidence of SSIs, the duration for DPC, the incidence of fascial dehiscence, the number of NPWT dressing changes, and the length of hospital stay were documented according to CDC groups. Results The mean age in CDC categories 2, 3, and 4 were 31.789, 28.733, and 42.676 years, respectively. The most common cause of perforation was enteric fever (n = 42, 28%), followed by tuberculosis (n = 36, 24%). Most patients had no known comorbidities (n = 80, 53.3%). Overall, 16% of patients (n = 24) were both alcoholics and smokers. The most frequent bacteria in all CDC categories was . Fourteen patients developed burst abdomen in the postoperative period and were excluded from the study. The mean duration of DPC increased with higher CDC categories, with CDC category 4 displaying the most extended mean duration at 10.70 days. The number of NPWT dressing changes increases with higher CDC categories, with CDC category 4 exhibiting the highest mean at 2.00 changes. The mean hospital stay increased with higher CDC categories, with CDC category 4 showing the most extended mean stay at 17.324 days. Statistical analysis revealed no significant association between SSI occurrence and CDC categories. Conclusions NPWT followed by DPC is a promising approach to managing gastrointestinal perforations, reducing SSIs, and potentially improving patient outcomes. However, further research is needed to explore the specific benefits of NPWT in conjunction with DPC and its efficacy in various clinical scenarios.
PubMed: 38903365
DOI: 10.7759/cureus.60738 -
Scientific Reports Jun 2024Southern right whales (SRWs, Eubalaena australis) have been observed feeding both at and below the surface (< 10 m) in Golfo Nuevo (42°42' S, 64°30' W), Península...
Southern right whales (SRWs, Eubalaena australis) have been observed feeding both at and below the surface (< 10 m) in Golfo Nuevo (42°42' S, 64°30' W), Península Valdés, Argentina, an area traditionally recognized as calving ground. In addition, we documented diving feeding behavior in SRWs during their stay in this gulf, which has not been previously described. We assessed this behavior using suction-cup-attached video-imaging tags (CRITTERCAMs) on individual whales. A total of eight CRITTERCAM deployments were successful, and feeding events were documented in all SRWs successfully equipped with CRITTERCAMs. The highest speeds occurred during the ascent phase, and the average diving time was 6 min 45 s ± 3 min 41 s for SRWs. Concurrently, zooplankton samples were collected from the subsurface and bottom of the water in areas where tagged whales dived to assess differences in composition, abundance, and biomass. Copepods dominated the upper layer, while euphausiids were more abundant in the deeper sample. Furthermore, zooplankton total biomass was five times higher at depth (2515.93 mg/m) compared to the subsurface (500.35 mg/m). Differences in zooplankton characteristics between depths, combined with CRITTERCAM videos, indicated that SRWs exploit high concentrations of organisms near the seafloor during daytime feeding dives. This study provides baseline insights into how SRWs utilize Península Valdés during their stay in the area.
Topics: Animals; Argentina; Zooplankton; Whales; Feeding Behavior; Diving; Predatory Behavior
PubMed: 38902303
DOI: 10.1038/s41598-024-63879-y -
Microplastics alter soil structural stability as quantified by high-energy moisture characteristics.Journal of Hazardous Materials Jun 2024Microplastics (MiPs) can potentially influence soil structural stability, with impacts likely dependent on their chemistry, concentration, size, and degradation in soil....
Microplastics (MiPs) can potentially influence soil structural stability, with impacts likely dependent on their chemistry, concentration, size, and degradation in soil. This study used high-energy moisture characteristics (HEMC; water retention at matric suctions from 0 to 50 hPa) to quantify the effects of these MiP properties on soil structure stabiltiy. The HEMCs of soil samples contaminated with polypropylene (PP) or polyethylene (PE) were measured and modelled. Greater MiP concentrations (2 % and 7 % w w) increased the volume of drainable pores (VDP). At smaller MiP concentrations (0.5 % and 1 % w w), larger MiP fibres (3 and 5 mm) exhibited higher VDP values compared to a smaller size (1.6 mm) across a range of concentrations. Both PE and PP MiPs increased the modal matric suction (h). The impacts on VDP and h were more pronounced for fast than slow wetting, likely due to MiPs fibres entangling around soil aggregates, and MiPs pores filling after aggregate slaking, respectively. Soil structural index (SI) and stability ratio (SR) values increased following MiP incorporation. Our findings revealed the detrimental impacts of MiPs on soil aggregates and pores, demonstrating that MiPs significantly influence HEMC parameters due to combined impacts on structure stability and pore distribution. ENVIRONMENTAL IMPLICATION: Microplastics have emerged as a major anthropogenic hazardous material in the soil environment, with secondary impacts on soil structure and aggregate stability. Our study indicates that MiPs alter water retention, pore distribution, and soil hydraulic properties, affecting soil's ability to retain and supply water. The introduction of MiPs leads to the destruction of soil aggregates and pores, compromising soil health and productivity. By characterising structural stability and pore structure dynamics using HEMC, this study highlights the sensitivity of MiP impacts, emphasizing the need for comprehensive assessment and strategies to preserve soil ecosystem functioning in the face of increasing MiP pollution.
PubMed: 38901260
DOI: 10.1016/j.jhazmat.2024.134940 -
JFMS Open Reports 2024A 5-month-old male castrated domestic shorthair cat was evaluated for acute onset of emesis. Abdominal radiographs identified a suspected colonic foreign body and...
CASE SUMMARY
A 5-month-old male castrated domestic shorthair cat was evaluated for acute onset of emesis. Abdominal radiographs identified a suspected colonic foreign body and abdominal-focused assessment with sonography for trauma, triage and tracking (AFAST) evaluation revealed a large amount of peritoneal effusion. Cytology of the peritoneal effusion was consistent with a septic exudate. An exploratory celiotomy identified a ruptured ileocecocolic mass and a resection and anastomosis was performed. No foreign material was identified and histopathology confirmed that the ruptured mass was a colonic duplication cyst. Recurrent septic peritonitis was diagnosed based on cytologic evaluation of fluid from a silicone bulb reservoir of a closed suction drain. No abnormalities were surgically identified, the cat recovered without complication, was discharged at 7 days postoperatively and has continued to remain healthy 8 months after surgical intervention.
RELEVANCE AND NOVEL INFORMATION
To our knowledge, this is the first known instance of a histopathologically confirmed non-communicating colonic duplication cyst causing septic peritonitis in the veterinary literature.
PubMed: 38895130
DOI: 10.1177/20551169241256555 -
An Adjustable Pneumatic Planter with Reduced Source Vibration for Better Precision in Field Seeding.Sensors (Basel, Switzerland) May 2024The growing demand for agricultural output and limited resources encourage precision applications to generate higher-order output by utilizing minimal inputs of seed,...
The growing demand for agricultural output and limited resources encourage precision applications to generate higher-order output by utilizing minimal inputs of seed, fertilizer, land, and water. An electronically operated planter was developed, considering problems like ground-wheel skidding, field vibration, and the lack of ease in field adjustments of ground-wheel-driven seed-metering plates. The seed-metering plate of each unit of the developed planter is individually driven by a brushless direct current (BLDC) motor, and a BLDC motor-based aspirator is attached for pneumatic suction of seeds. The revolutions per minute (RPM) of the seed-metering plate are controlled by a microcontroller as per the received data relating to RPM from the ground wheel and the current RPM of the seed-metering plate. A feedback loop with proportional integral derivative (PID) control is responsible for reducing the error. Additionally, each row unit is attached to a parallelogram-based depth control system that can provide depth between 0 and 100 mm. The suction pressure in each unit is regulated as per seed type using the RPM control knob of an individual BLDC motor-based aspirator. The row-to-row spacing can be changed from 350 mm to any desired spacing. The cotton variety selected for the study was RCH 659, and the crucial parameters like orifice size, vacuum pressure, and forward speed were optimized in the laboratory with the adoption of a central composite rotatable design. An orifice diameter of 2.947 mm with vacuum pressure of 3.961 kPa and forward speed of 4.261 km/h was found optimal. A quality feed index of 93% with a precision index of 8.01% was observed from laboratory tests under optimized conditions. Quality feed index and precision index values of 88.8 and 12.75%, respectively, were obtained from field tests under optimized conditions.
PubMed: 38894193
DOI: 10.3390/s24113399 -
Diagnostics (Basel, Switzerland) May 2024Endotracheal suctioning is an essential but labor-intensive procedure, with the risk of serious complications. A brand new automatic closed-suction device was developed...
Clinical Efficacy and Safety of an Automatic Closed-Suction System in Mechanically Ventilated Patients with Pneumonia: A Multicenter, Prospective, Randomized, Non-Inferiority, Investigator-Initiated Trial.
Endotracheal suctioning is an essential but labor-intensive procedure, with the risk of serious complications. A brand new automatic closed-suction device was developed to alleviate the workload of healthcare providers and minimize those complications. We evaluated the clinical efficacy and safety of the automatic suction system in mechanically ventilated patients with pneumonia. In this multicenter, randomized, non-inferiority, investigator-initiated trial, mechanically ventilated patients with pneumonia were randomized to the automatic device (intervention) or conventional manual suctioning (control). The primary efficacy outcome was the change in the modified clinical pulmonary infection score (CPIS) in 3 days. Secondary outcomes were the frequency of additional suctioning and the amount of secretion. Safety outcomes included adverse events or complications. A total of 54 participants, less than the pre-determined number of 102, were enrolled. There was no significant difference in the change in the CPIS over 72 h (-0.13 ± 1.58 in the intervention group, -0.58 ± 1.18 in the control group, = 0.866), but the non-inferiority margin was not satisfied. There were no significant differences in the secondary outcomes and safety outcomes, with a tendency for more patients with improved tracheal mucosal injury in the intervention group. The novel automatic closed-suction system showed comparable efficacy and safety compared with conventional manual suctioning in mechanically ventilated patients with pneumonia.
PubMed: 38893595
DOI: 10.3390/diagnostics14111068 -
Molecules (Basel, Switzerland) May 2024Drilling through shale formations can be expensive and time-consuming due to the instability of the wellbore. Further, there is a need to develop inhibitors that are...
Drilling through shale formations can be expensive and time-consuming due to the instability of the wellbore. Further, there is a need to develop inhibitors that are environmentally friendly. Our study discovered a cost-effective solution to this problem using Gum Arabic (ArG). We evaluated the inhibition potential of an ArG clay swelling inhibitor and fluid loss controller in water-based mud (WBM) by conducting a linear swelling test, capillary suction timer test, and zeta potential, fluid loss, and rheology tests. Our results displayed a significant reduction in linear swelling of bentonite clay (Na-Ben) by up to 36.1% at a concentration of 1.0 wt. % ArG. The capillary suction timer (CST) showed that capillary suction time also increased with the increase in the concentration of ArG, which indicates the fluid-loss-controlling potential of ArG. Adding ArG to the drilling mud prominently decreased fluid loss by up to 50%. Further, ArG reduced the shear stresses of the base mud, showing its inhibition and friction-reducing effect. These findings suggest that ArG is a strong candidate for an alternate green swelling inhibitor and fluid loss controller in WBM. Introducing this new green additive could significantly reduce non-productive time and costs associated with wellbore instability while drilling. Further, a dynamic linear swelling model, based on machine learning (ML), was created to forecast the linear swelling capacity of clay samples treated with ArG. The ML model proposed demonstrates exceptional accuracy (R score = 0.998 on testing) in predicting the swelling properties of ArG in drilling mud.
PubMed: 38893388
DOI: 10.3390/molecules29112512 -
International Journal of Molecular... May 2024The genus (bladderworts) species are carnivorous plants that prey on invertebrates using traps with a high-speed suction mechanism. The outer trap surface is lined by...
The genus (bladderworts) species are carnivorous plants that prey on invertebrates using traps with a high-speed suction mechanism. The outer trap surface is lined by dome-shaped glands responsible for secreting water in active traps. In terminal cells of these glands, the outer wall is differentiated into several layers, and even cell wall ingrowths are covered by new cell wall layers. Due to changes in the cell wall, these glands are excellent models for studying the specialization of cell walls (microdomains). The main aim of this study was to check if different cell wall layers have a different composition. Antibodies against arabinogalactan proteins (AGPs) were used, including JIM8, JIM13, JIM14, MAC207, and JIM4. The localization of the examined compounds was determined using immunohistochemistry techniques and immunogold labeling. Differences in composition were found between the primary cell wall and the cell secondary wall in terminal gland cells. The outermost layer of the cell wall of the terminal cell, which was cuticularized, was devoid of AGPs (JIM8, JIM14). In contrast, the secondary cell wall in terminal cells was rich in AGPs. AGPs localized with the JIM13, JIM8, and JIM14 epitopes occurred in wall ingrowths of pedestal cells. Our research supports the hypothesis of water secretion by the external glands.
Topics: Cell Wall; Mucoproteins; Plant Proteins; Lamiales; Immunohistochemistry
PubMed: 38892273
DOI: 10.3390/ijms25116089 -
BMC Musculoskeletal Disorders Jun 2024Suction drainages are commonly used after total knee arthroplasty (TKA) procedures; however, their use is somewhat controversial. Recently, some reports have claimed...
BACKGROUND
Suction drainages are commonly used after total knee arthroplasty (TKA) procedures; however, their use is somewhat controversial. Recently, some reports have claimed that the administration of tranexamic acid (TXA) may prevent postoperative bleeding following TKAs. Although numerous studies have reported regarding different dosages, timings of administration, or drain clamping times for intravenous and intra-articular TXA injections (IA-TXAs), few have examined whether suction drainage is necessary when TXA is administered. In this study, we compared using suction drainage without TXA administration and IA-TXA without suction drainage and aimed to examine the need for suction drainage during IA-TXA.
METHODS
This retrospective study was conducted on 217 patients who had received TKA for osteoarthritis; 104 were placed on suction drainage after TKA without TXA (Group A), whereas the remaining 113 received IA-TXA immediately after surgery without suction drainage (Group B). Our clinical evaluation included assessments of the need for transfusion, presence of postoperative complications, incidence of deep vein thrombosis (DVT), and changes in hemoglobin (Hb), hematocrit (Hct), and D-dimer levels.
RESULTS
No significant differences were observed in terms of postoperative complications and preoperative Hb, Hct, or D-dimer levels between the two groups. Although the prevalence of DVT was significantly higher in Group B (p < 0.05), all cases were asymptomatic. Hb and Hct levels were significantly lower in Group A than in Group B at 1, 3, 7, and 14 days postoperatively (p < 0.05), although none of the cases required blood transfusions. D-dimer levels were significantly higher in Group A than in Group B at 1 and 3 days postoperatively (p < 0.05).
CONCLUSION
Suction drainage might not be necessary when IA-TXA is administered after TKA procedures.
Topics: Humans; Tranexamic Acid; Retrospective Studies; Arthroplasty, Replacement, Knee; Female; Male; Aged; Suction; Injections, Intra-Articular; Antifibrinolytic Agents; Middle Aged; Postoperative Hemorrhage; Aged, 80 and over; Osteoarthritis, Knee; Venous Thrombosis; Treatment Outcome
PubMed: 38890633
DOI: 10.1186/s12891-024-07604-w